MRSA-was it always so?

[Vlad_Dracul]

I have a relative in hospital following surgery. After spending three weeks on our crummy,outdated victorian wards she has now tested positve for MRSA and has been moved to an equally crummy side room. Across the corridor is another patient in a similar position.
I have a number of points:

1)Why,in the year 2006,do we still have inhumane,crummy hospital wards in clapped out victorian ex nuthouse type builidngs?

2) Was MRSA always with us, even in the days of Matron, or is it just red top tabloid hysteria?

3) Is the problem as evident and widespread in other countries?


I must say that i have evidence of the health services in other euro countries and generally, we have nothing to be proud of. This doesn't detract from or criticise the individual efforts of clinicians and nurses. It is a deeper routed systemic problem. What is needed is root and branch reform-in short I would place the running of the NHS in private hands with a government watchdog in place.

A couple of years ago i had occasion to go to Spain to visit a relative who had taken ill. For reference, she was in the Spanish state hospital Son Dureta in Palma De Mallorca. I was amzed at the difference to be honest. No hoards of people waiting/screaming for attention, no hospital wards, good food and the best attention from the nursing staff and doctors. The accomodation comprised separate rooms in which two patients were housed. Each room had its own bathroom/toilet/shower, pay tv and pay phone. The food was of a high standard and plentifull and the nurses couldnt do enough for you.


I read recently that a lot of UK hospital patients suffer malnutrition in hospitals. I'm not surprised. Sometimes the evening meal consists only of a sandwich and a mug of tea! Sounds more like a scene from Tenko. The place is so arcahiac that even in the sweltering temperatures we have of late,the heating is on full blast. Its so clapped out that they dare not shut it down becuase it takes so long to get going again. Meanwhile patients bake-no aircon.the lucky ones or the ones who shout loudest,get a fan.

Lets throw away our rose tinted specs. The NHS is knackered. It has been for a long time and needs major surgery itself. Put it in the hands of privateers,businessmen who know how to run a business AND deliver a decent level of serivce,closely monitored by Government,its paymasters. Not the run down,fat,bloated wasteful organisation it is now.

[homealone]

MRSA has only been with us since the introduction of antibiotics as a treatment for infections, the problem is, that it has gradually become resistant to most of the antibiotics available today.

I believe over-reliance on antibiotics has both helped MRSA to develop this resistance, and also made us complacent about hygiene standards that can contribute to its transmission between patients.

[Damien]

1)Why,in the year 2006,do we still have inhumane,crummy hospital wards in clapped out victorian ex nuthouse type builidngs?

Depends where you are. There are quite a few new hospitals built in the last 10 years which are more modern because of it. A lot of city hospitals are old and victorian because thats when they were built. Obviously inner city hospitals made more sense then out of town ones then. This means the buildings are condensed and old.

2) Was MRSA always with us, even in the days of Matron, or is it just red top tabloid hysteria?

Always with us. It just as we get on they become more resistant. Also it is belived in the past we missed a lot of the infections.

3) Is the problem as evident and widespread in other countries?

Good question.

Originally Posted by dooper786

1)Why,in the year 2006,do we still have inhumane,crummy hospital wards in clapped out victorian ex nuthouse type builidngs?

2) Was MRSA always with us, even in the days of Matron, or is it just red top tabloid hysteria?

3) Is the problem as evident and widespread in other countries?

1/ Ask the hospital management, they are the ones that have all but done away with cleaners and given themselves pay rises.

2/ MRSA will have been with us since the dawn of time, just probably was unknown until fairly recently

3/ I'd guess so, its just we highlight it more in the UK

[Rob]

Standards of hygiene are the key here. Cost cutting and contracting out so that cleaners and more importantly the company that pays them is trying to make money by doing the minimum they have to, leads to the risk of infections being passed. Hospitals have always been at risk of transmiting infections, after all they will be a breeding ground simply due to the warm conditions needed for patient comfort.

It's going to be less about the building age, more about how well it's maintained. Most Victorian era buildings were substantially overdesigned and built from a structural point of view. I wonder how many of today's buildings will still be standing in 100 years? The issue is the lack of versatility for modern healthcare needs that the older building floorspace does not allow, and perhaps higher running costs of the older building fabric.

[TheDaddy]

Originally Posted by Rob C

Standards of hygiene are the key here. Cost cutting and contracting out so that cleaners and more importantly the company that pays them is trying to make money by doing the minimum they have to, leads to the risk of infections being passed. Hospitals have always been at risk of transmiting infections, after all they will be a breeding ground simply due to the warm conditions needed for patient comfort.

It's going to be less about the building age, more about how well it's maintained. Most Victorian era buildings were substantially overdesigned and built from a structural point of view. I wonder how many of today's buildings will still be standing in 100 years? The issue is the lack of versatility for modern healthcare needs that the older building floorspace does not allow, and perhaps higher running costs of the older building fabric.

And yet people want more private business involved in the NHS, imo this is not the answer as the bottom line with them is profit, not what they can put in but what they can take out.

[homealone]

Originally Posted by Rob C

Standards of hygiene are the key here. Cost cutting and contracting out so that cleaners and more importantly the company that pays them is trying to make money by doing the minimum they have to, leads to the risk of infections being passed. Hospitals have always been at risk of transmiting infections, after all they will be a breeding ground simply due to the warm conditions needed for patient comfort.

It's going to be less about the building age, more about how well it's maintained. Most Victorian era buildings were substantially overdesigned and built from a structural point of view. I wonder how many of today's buildings will still be standing in 100 years? The issue is the lack of versatility for modern healthcare needs that the older building floorspace does not allow, and perhaps higher running costs of the older building fabric.

Good points there, Rob,

One from me - the SA bit of the MRSA stands for Staphylococcus aureus, a bacteria many of us carry in our noses.

Some people are capable of carrying MRSA strains without harm to themselves, but can pass them on

I remember in the 'old days' of hospitals, from my perspective of it, that visiting was a lot more restricted than it is now.??

- so, as MRSA affects already poorly people, more, then one way of reducing it could be to reduce 'visitors' to the hospital

- I can see that going down well, these days

[Rob]

Originally Posted by TheDaddy

And yet people want more private business involved in the NHS, imo this is not the answer as the bottom line with them is profit, not what they can put in but what they can take out.

Contracting or outsourcing is probably not the subject of this thread, but I can see that it has some benefits, if used widely, but the blanket apply to everything approach is foolish. If we actually want the later then why not have done with it and drop the idea of the NHS and indeed most state controlled services altogether. But I digress.

There can be cost savings, and innovation by contracting out. The savings are probably less true today, since most in house services will have been measured against the privateers, but that was not always the case. However I do wonder how much behind the scenes, and inadequately costed extra layers of red tape, and management are created to monitor the performance of the contractors.

But to get back to the subject of infection control, I must say I was impressed with the national blood service setup the other day at a local hall. Every one of the portable "beds" had a cleanser dispenser, which every staff member who got near you used before they touched you, or any kit near the bed. A few years ago they gave you a perspex tube to roll in your hand while your arm emptied. That's gone in the name of infection control too - you're just told to flex your fingers. Just goes to show that a lot of infection control is basic common sense and simple procedures, and one that average joe public must do it's best to respect and follow.

[Vlad_Dracul]

Originally Posted by Rob C

Contracting or outsourcing is probably not the subject of this thread, but I can see that it has some benefits, if used widely, but the blanket apply to everything approach is foolish. If we actually want the later then why not have done with it and drop the idea of the NHS and indeed most state controlled services altogether. But I digress.

There can be cost savings, and innovation by contracting out. The savings are probably less true today, since most in house services will have been measured against the privateers, but that was not always the case. However I do wonder how much behind the scenes, and inadequately costed extra layers of red tape, and management are created to monitor the performance of the contractors.

But to get back to the subject of infection control, I must say I was impressed with the national blood service setup the other day at a local hall. Every one of the portable "beds" had a cleanser dispenser, which every staff member who got near you used before they touched you, or any kit near the bed. A few years ago they gave you a perspex tube to roll in your hand while your arm emptied. That's gone in the name of infection control too - you're just told to flex your fingers. Just goes to show that a lot of infection control is basic common sense and simple procedures, and one that average joe public must do it's best to respect and follow.

Yes,i am a regular blood donor and the facilities and staff are excellent. They can actually insert a needle without killing you or making you look like a purple dart board, as they do in many hospitals where it sems staff are prety useless at doing this.

[BBKing]

2) Was MRSA always with us, even in the days of Matron, or is it just red top tabloid hysteria?

Nope. Hospitals were cleaned properly until the mid-80s, when Thatcherite reforms inspired by head-in-clouds wonks like the Adam Smith Institute hived the cleaning off to the lowest bidder, who worked down to a price, sacked the existing cleaners and hired anyone desperate enough for the money (and no unions, either). Result - poor cleaning, Matron no longer being in charge (cleaners work for their boss, not the NHS) and MRSA.

All of which tends to suggest that hiving it off to private hands isn't necessarily the solution. As for outdated hospitals, sorry, but the money's gone on 25-30 year PFI deals, which have often lead to smaller hospitals being built out of town and in one case the state is paying for 27 years for a hospital that isn't needed any more, because the contract means the supplier gets the cash whether or not there's actually anyone treated.